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Sohair El-Batea’s story is not uncommon in Egypt: a 13-year-old girl from a Nile Delta village was sent for an illegal circumcision by her parents to the local clinic. Something went wrong and she died en route to hospital.

The autopsy revealed Sohair, whose sisters had been cut by the same doctor, died from “shock trauma”. Staff at the hospital, who tried to revive the teenager, told her mother the doctor drugged Sohair without the supervision of an anaesthesiologist.

Sohair’s father, a farmer, defended his decision, telling local media that neighbours recommended the physician, someone with “a remedy for everything at low prices”. The family was allegedly told by the clinic to say nothing further.

Human rights groups feared that, as usual, nobody would be held accountable for Sohair’s death, and, sure enough, on Wednesday, the doctor responsible was released without charge.

Sohair’s is not the first death to make headlines. In 2010 another 13-year-old, Nermine El-Haddad, bled to death in a hospital, post-operation. Three years before that, two girls of a similar age died, leading parliament to criminalise the practice. One of their mothers told local media she paid just £5.50 for the operation.

Despite the practice being illegal, Egypt has among the highest rates of female genital mutilation (FGM) in the world. In the post Arab Spring upheaval, and with Islamist MPs pushing decriminalisation of the practice in Parliament, activists fear FGM may become more acceptable.

It is estimated that a staggering 91 per cent of women between the ages of 15-49 have been cut, according to the latest survey released in 2008, meaning a cross-section of society, from working-class rural communities to middle-class professionals, put their young daughters under the knife. “It occurs across class boundaries but is of course linked to lack of education and information,” explains Sally Zohney, a feminist working on the issue.

Female circumcision is practised in both Muslim and Christian communities, although Egypt’s Coptic Christian Church and Al-Azhar, the country’s leading Islamic authority, have condemned it. Al-Azhar refuted claims that FGM is sanctioned by Islam.

Cutting, which is rarely practised in other Arab countries, has its roots in African tradition. “There is a strong link between circumcising a girl and protecting her honour, her virginity,” explains Zohney. Many believe removing the clitoris will control women’s “desires” and therefore their behaviour. Although often initiated by female family members, many men will only marry girls who are cut, Zohney adds.

Egyptian women are typically circumcised between the ages of eight and 12. “They either remove a small piece or the whole clitoris,” explains Hussein Gohar, an Egyptian gynaecologist and vocal critic of the practice. Little attention is paid to hygiene and the operations are often done without anaesthetic.

In extreme cases, Gohar continues, the labia is removed “which leaves just a hole”.

“You run the risk of heavy bleeding, sometimes to death,” he adds. Other possible consequences include infection, cysts and scarring which can make sex excruciating and lead to “uncontrollable tearing” during childbirth.

The rite of passage is extremely traumatic, says Salma [not her real name], who was circumcised at the age of nine in a rundown Islamic Cairo district. “I woke up one morning to find three women dressed in black in my room. They sprayed something cold inside me, one held my arms, one my legs,” she says. “I couldn’t understand why they were restraining me — I tried to push them away. Then they cut me. They said nothing.”

Salma considers herself lucky: her cousin, who bled for days, couldn’t walk for a week.

Girls are not prepared for what happens, nor is the process explained to them. “I had problems with my husband, I am not interested in sex, it damaged my marriage. It’s like a bad dream you can never forget,” says Salma.

The United Nations children’s organisation Unicef reports that despite the ban on FGM, 72 per cent of operations are now performed by doctors. They can make a tidy sum on the side: prices start at £14, with some raking in as much as £150.

“Hospitals can be blamed and spotted more easily because FGM is illegal,” says Zohney, who adds that private clinics are the preferred venue, where the quality of care and the level of discretion depend on the price.

Magda Naguib, from the Better Life Association, explains that doctors are recommended by word of mouth and compete for business. “Families visit them early in the morning and late at night because it’s criminalised,” says Naguib.

Doctors often know little about the potential danger of FGM. Circumcision, Gohar explains, is barely discussed in the university medical syllabus. “Some professors in gynaecology even advocate FGM,” he adds. Physicians occasionally perform the procedure without the patient’s consent: Ghada Shahbender of the Egyptian Organisation of Human Rights relates one story of a domestic helper who noticed her wounds were not healing after a difficult birth.

“Her doctor had circumcised her during delivery on the instructions of her husband,” Shahbender says.

Despite all this evidence, politicians last year discussed allowing doctors to perform FGM. “What Sohair’s case highlights is that it is not a safe procedure, even when it happens in a medical setting,” says Priyanka Motaparthy, a children’s rights researcher.

Other rights advocates fear campaigns against the practice will continue to face obstacles. Local media reported in 2011 that the Muslim Brotherhood was offering subsidised female circumcision at mobile clinics for the equivalent of £3. Video footage of the clinics circulated on social media, though no one has confirmed the story and the group subsequently denied it.

Nevertheless the Brotherhood continues to make controversial statements. In March 2012 Azza El-Garf, one of the only female MPs from the Brotherhood’s Freedom and Justice Party (FJP), described FGM as “beautification surgery” that should be allowed.

During a televised debate last year President Mohamed Morsi was asked about the problem. “His response was basically to say it is a personal issue between mother and daughter,” explained Zohney.

None of the FJP parliamentarians in Daqahlia governorate, where Sohair died, would comment on her death. Some contacted by the Evening Standard hung up when FGM was mentioned.

“We have more pressing issues,” says Saad Aly Abdel-Holougy, Brotherhood MP in Daqahlia. He did add that the FJP is against female circumcision.

Motaparthy fears the law is not being enforced: “We’re seen little attempt to investigate these instances.” There are still 12 pending criminal cases from 2010 where parents and doctors were accused of carrying out FGM, and activists complain that police tasked with enforcing the law probably circumcise their own daughters.

The most prominent figure to criticise FGM before the Arab Spring was Suzanne Mubarak, wife of the deposed president. “When the Muslim Brotherhood and its offshoots speak of women’s rights legislation they call them Suzanne Mubarak laws intentionally, to give them a bad name,” explains Shahbender.

The association with Mubarak has become so acute that women’s rights activists chant “we are not Suzanne Mubarak’s dogs” during marches.

One year into President Morsi’s rule, activists say Egypt is backtracking on personal rights: groups complain that the newly adopted constitution does not prevent the abuse of children, and orders women to prioritise family life.

“Instead of gaining new laws for women’s rights, we are on the defensive to protect established legislation,” says Zohney, fearing that the number of girls subjected to this brutal practice will not diminish: “We can’t look forward.”